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Limb-Lengthening Surgery

Lengthening surgery is performed by lengthening the leg for aesthetic reasons or for health reasons in individuals whose height is below the average (dwarfism, achondroplasia).

What is Limb-Lengthening Surgery?

Lengthening surgery is a device-assisted orthopedic procedure that increases the length of the lower or upper leg, or both, using the technique of distraction osteogenesis. This method is based on the principle of allowing the cut bone to heal and grow longer on its own.

Why is Limb-Lengthening Surgery Performed?

Leg lengthening surgery is often performed to address social and psychological challenges posed by being below average height. It can also be used by individuals who desire to appear taller, even if they are not below the average height. The procedure is also used to treat dwarfism and eliminate orthopedic disorders caused by unequal limb length, also known as limb height inequality.

What is Limb Inequality?

Limb height inequality refers to the difference in height between the legs or arms. Shortness of the lower limb and unequal leg length are different conditions and can be treated using the same techniques and devices used in lengthening surgeries.

Who Can Have Limb-Lengthening Surgery?

Lengthening surgery, which was previously only performed for medical reasons, is now also offered for cosmetic reasons. The procedure is typically recommended for:

  • Adult men and women who are below average height with closed growth plates

  • Children over 4 years of age with symptoms of dwarfism

  • Healthy adult men and women who are not satisfied with their height and/or desire to appear taller, even if they are not below average

  • Children and adults with limb height inequalities, such as disparities caused by previous fractures or illnesses.

Types of Lengthening Surgery

Advances in orthopedic surgery technology have had a positive impact on lengthening surgeries, offering a diversity of devices and surgical methods. Patients can benefit from choosing the most suitable method for their age and the purpose of their height increase surgery. Additionally, the cost of these methods varies, providing alternative surgery options for those seeking lengthening surgery. Currently, the methods used in lengthening surgeries are categorized into three main categories: External Fixation using Ilizarov Circular Fixator, Internal Fixation using Motorized Nail Technique, and Combined Length Lengthening Surgery using both internal and external fixation.

How is the Limb-Lengthening Surgery Performed?

Lengthening surgeries can be performed under general or spinal anesthesia. The operation time takes 1.5/2 hours depending on the technique to be used. Lengthening is usually performed by lengthening the shin or thigh bone. In some cases, it is possible to lengthen both the shinbone and the femur.


According to the preoperative planning and the method to be used, the bone is reached with small incisions and the bone is cut transversely. Then, the stabilizers that will provide the gradual lengthening of the cut bone are fixed to the leg.


After that, it constitutes the second stage of the lengthening surgery. In order to achieve an average of 1-millimeter bone lengthening every day, the cut bone is removed from each other with the help of the device. Depending on the trauma, the body is expected to be stimulated to repair the bone. The body produces tissue to close the gap between the receding bones (lengthening time + 1.5 fold the lengthening time). In the end, lengthening of the cut bone is obtained.

After Lengthening Surgery

The lengthening procedure and post-operative process are different for adults and children. Children's growth plates are active, which means the targeted lengthening is achieved in a shorter time, but the device must be used for a longer period in adults. It typically takes 6 months to 1 year for the device to be removed and the bone to fully heal in adults. After removal, physical therapy and rehabilitation are necessary for a successful recovery. Pain after lengthening surgery is not severe but cannot be considered a painless process. The bone tissue formed after surgery is as strong as other bones in the body and can be used without problems for life. The risk of fracture is the same as the untreated leg bone.

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